5 Things Not to Say to Someone Who’s Had Weight-Loss Surgery

Weight-loss surgery has always been a topic of conversation and intrigue. After New Jersey Governor Chris Christie underwent Lap-Band surgery (in which a silicone band is placed around the upper part of the stomach to shrink it) in 2013, the media went crazy, questioning how much weight he’d lost, why he didn’t look even thinner, and whether or not he had failed in his efforts to slim down.

Although many weight-loss patients are open about their experiences, there are still some questions that are simply insensitive or inappropriate to ask, whether or not you realize it. Brian Smith, MD, a bariatric surgeon at University of California Irvine, weighs in on some of the most common (and offensive) remarks, and why you should keep your mouth closed.

Don’t say: “You’re so lucky you can eat anything you want now!”

Surgery doesn’t prevent you from gaining weight—it just limits the amount of food your stomach can hold, helping you fill up faster. It also doesn’t grant you a free pass to eat whatever you’d like. In fact, each procedure often carries its own set of digestive restrictions. “Lap-Band patients can’t eat bread because it’s bulky and can get stuck in the stomach, while gastric bypass patients have to be careful with concentrated sweets, because they immediately travel to the small intestine and cause cramping and diarrhoea,” says Dr. Smith. “Even the sleeve gastrectomy, which is a newer and more preferred method, can come with food intolerances, so you really have no idea what issues a person may be dealing with after surgery,” he explains.

Don’t ask: “Why didn’t you just try dieting and exercising?”

Bariatric surgery is not a lazy person’s way of getting out of going to the gym or eating a few veggies. “Many people who seek out surgery do so because of medical conditions that make it difficult or impossible to lose weight, like hypothyroidism, depression, endocrine disorders, or arthritis,” explains Dr. Smith. Even for people without medical issues, weight-loss surgery is generally a last-ditch attempt and reserved only for those with BMIs 35 and over, which is about 100 pounds overweight. “People who decide to undergo weight-loss surgery aren’t taking the easy road—it’s still incredibly hard,” Dr. Smith says. “It takes discipline and courage to go through an invasive procedure, overcome it, deal with post-op recovery, and then start doing cardio for an hour, five times a week, for the rest of your life to maintain your new weight.”

Don’t ask: “Do you have a lot of extra skin?”

This one should be a no-brainer, but unfortunately, it still gets asked. “This is obviously a very personal question that I would refrain from asking, especially if a patient is struggling with their body image or considering having more work done to remove the skin,” says Dr. Smith. And, contrary to what you see on TV or in movies, excess skin isn’t even the expected norm after weight loss surgeries. “Younger people with lower BMIs tend to have less sag and more elasticity, and the minority of patients end up needing to have any form of body contouring post-surgery,” he adds.

Don’t say: “You don’t look like you’ve lost that much weight.”

Weight-loss surgery isn’t a magical makeover that leaves you 80 pounds lighter right out of the hospital; it’s a slow, difficult process that gradually happens over the course of a year. “You’re not actually having any fat removed during the surgery, so you can’t expect a patient to look radically different within a few weeks afterwards,” says Dr. Smith. “We rate the expected weight loss after one year, so if you’re 100 pounds overweight, you’re expected to lose 40-70 pounds after a year, depending on the surgery.” Hopefully, you wouldn’t tell your friend that her extra hours at the gym aren’t paying off, so you shouldn’t mention a patient’s post-op size, either.

Don’t ask: “So you’ll lose weight without having to do anything?”

It’s important to remember that weight-loss surgery is not a quick, magical fix—it’s just a jump start. “Bariatric surgery essentially handicaps you and thrusts you into weight loss, forcing you to adopt a healthier lifestyle,” says Dr. Smith. “No operation will succeed long-term if a patient doesn’t commit to diet and exercise to keep the weight off. So by chalking up a person’s entire weight loss to their surgery, you’re actually robbing them of everything they’ve put themselves through, which is the fight of surgery, the pain, the courage it took to get there, and all the diet and exercise they’ve completed post-surgery,” notes Dr. Smith.

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‘Love Your Body’ to Lose Weight

Almost a quarter of men and women in England and over a third of adults in America are obese. (In South Africa statistics on the percentage of overweight and obese people indicate that obesity and its co-morbidities are on the increase, with Cape Town leading the way!) Obesity increases the risk of diabetes and heart disease and can significantly shorten a person's life expectancy. New research published by BioMed Central's open access journal International Journal of Behavioral Nutrition and Physical Activity shows that improving body image can enhance the effectiveness of weight loss programs based on diet and exercise.

Researchers from the Technical University of Lisbon and Bangor University enrolled overweight and obese women on a year-long weight loss program. Half the women were given general health information about good nutrition, stress management, and the importance of looking after yourself. The other half attended 30 weekly group sessions (the intervention plan) where issues such as exercise, emotional eating, improving body image and the recognition of, and how to overcome, personal barriers to weight loss and lapses from the diet were discussed. On the behavioral intervention plan women found that the way they thought about their body improved and that concerns about body shape and size were reduced. Compared to the control group they were better able to self-regulate their eating and they lost much more weight, losing on average 7% of their starting weight compared to less than 2% for the control group. Dr Teixeira from Technical University of Lisbon, who led the research, said, "Body image problems are very common amongst overweight and obese people, often leading to comfort eating and more rigid eating patterns, and are obstacles to losing weight. Our results showed a strong correlation between improvements in body image, especially in reducing anxiety about other peoples' opinions, and positive changes in eating behavior. From this we believe that learning to relate to your body in healthier ways is an important aspect of maintaining weight loss and should be addressed in every weight control program."

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Also known as bariatric surgery, weight loss surgery constitutes a number of procedures all with one goal in mind being weight loss for the patient suffering from obesity. Along with this primary goal, other effects from such procedures are an improvement in cardiovascular functions and decrease in associated risk or even full recovery from diabetes. The procedures involved can either make use of specific apparatus or even altering of the digestive organs.

Rules for Successful Dieting

Follows five basic rules:

Rule One: Eat Your Target Protein Every Day

By consuming the minimum amount of protein for your body, you maintain energy, muscle mass, and keep your hunger in check.Rule Two: Take Your Supplements Every Day
The daily nutritional supplements we prescribe to you will have a positive effect on your long-term health, energy, and longevity. Rule Three: Drink Water Every Day
As your body burns calories, waste products are released through urine. Drinking at least 64 ounces of water daily helps release these waste products so they don’t build up and slow your metabolism.Rule Four: Continue an Exercise Program
Getting the right amount of exercise is an essential part of successful long-term weight control and total well-being. Rule Five: Be Consistent with Your Diet
If you stick to your daily eating prescription and keep your caloric intake consistent from day to day, you increase your chances of maintaining your optimal weightGet your Maintenance Diet Plan today contact our resident Dietitian:Judy Kotze - Dietitian Special interest: Bariatric Nutrition BSc (Dietetics) - Diploma in Hospital Dietetics M (Nutrition) Durbanville Medi-Clinic Tel: 27-21 975 2336 Fax 27-21 9752692 Mobile: 083 254 0919

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Bariatric Surgery Support (BSS) is a Cape Town based Support Group for people seeking information and Support about Weight-Loss Surgery. We deal with a host of pre and post operation issues aimed at facilitating your journey to a healthier life style.

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Key Lifestyle Changes with Weight Loss Surgery

Some of the most important lifestyle changes to adapt to after weight loss surgery include:

* Slowly increasing physical activity
* Assessing and logging in daily food intake
* Undergoing counseling to adapt to the changing body image
* Eliminating social situations that promote overeating
* Tackling any emotional issues that triggered overeating with a therapist
* Making time to prepare special foods and meals to complement a healthier lifestyle